Accident & Health Claims Specialist (Executive / Senior Executive)
Hyppies Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
Join one of the most prominent insurance companies as an Accident & Health Claims Specialist (Executive / Senior Executive) ! This role involves accurate and fair processing of A&H claims within agreed timelines and ensuring compliance with policies, guidelines, and regulatory standards.
Key Responsibilities
- Assess and process Accident & Health (A&H) claims accurately and fairly within agreed timelines.
- Ensure all claims decisions comply with policy terms, internal guidelines, regulatory standards, and reinsurance arrangements.
- Conduct necessary investigations and liaise with claimants, medical providers, financial consultants, and other stakeholders to validate claims.
- Monitor and follow up on outstanding documents or information to support timely adjudication.
- Collaborate with internal teams to ensure smooth end-to-end claims handling and adherence to service level agreements.
- Handle customer enquiries and appeals with professionalism and empathy, ensuring a positive experience.
- Contribute to process and system improvement initiatives, including testing and feedback for system enhancements.
Qualifications & Experience
Minimum 1-2 years of experience handling Life or Health insurance claims.Good command of English, with proficiency in Mandarin (to manage invoices containing Chinese characters).Strong analytical, communication, and problem‑solving abilities.Customer‑focused mindset with resilience in handling pressure and complex cases.Self‑driven, organized, and capable of working independently with minimal supervision.Cooperative team player with maturity and accountability.#J-18808-Ljbffr